Raising the volume on the television, ignoring your family members, and having difficulty hearing in loud settings are some of the early warning signs that a patient may have hearing loss. Other factors, such as a history of noise damage or ear infections as a child, may also predispose patients to an early onset of hearing loss. Today, we will look at two tests that allow primary care doctors and otolaryngologists (ear-nose-throat doctors) to quickly diagnose the type of hearing loss a patient may have.
The first is the Weber test, which can detect unilateral (one-sided) conductive or sensorineural hearing loss. We will explore the difference between the two in a later edition of ENT Weekly; however, this is an important distinction as each has very different management strategies. In the test, a 512 Hertz vibrating tuning fork is placed in the middle of the forehead, flush against the surface. The patient is asked to report in which ear the sound is heard louder.
Image Source: Science and Society Picture Library
Usually accompanying the Weber test, the Rinne test is used as a back-up when the Weber test is inconclusive. Similarly to the Weber test, the Rinne test uses a 512 Hertz vibrating tuning fork. The physician places the fork against the patient’s mastoid bone and asks the patient to signal when the sound is no longer heard. Once this occurs, the still vibrating fork is quickly positioned one to two centimeters away from the ear, and the patient is asked if he or she can still hear the vibrations.
In a Weber test, a normal patient should report hearing the sound equally in both ears. In a normal Rinne test, sound conduction through air should be greater compared to the sound conduction through bone, such that the patient should be able to hear the fork next to the outer ear but should not be able to hear it when placed against the mastoid bone. Abnormal results will usually require a formal audiogram, in which the eardrum and auditory nerve are objectively tested, to further diagnosis the type of hearing loss.
Stay tuned next week as we explore more hearing problems that plague our ears!
Feature Image Source: Justin Chin